The specific objectives of this phase II SBIR effort are to design, implement, field test and evaluate an interactive multimedia and advanced telecommunication system for "Continuously Available Medical Care" (CAMC) targeted at the needs of aged patients. An "electronic network will link patients at home and in congregate sites to home health nurses, physicians in their offices and hospital emergency departments, providing 24 hour per day and 7 day per week service. Multi-point videoconferencing capabilities will allow simultaneous interaction of multiple providers in determining care needs of the elderly. Data will be collected on changes in health status for an experimental group compared to a usual care group. CAMC Systems can be of great benefit to the health care system by reducing hospital utilization, reducing nursing home utilization, reducing the volume of routine office visits, decreasing routine home health care visits, increasing the efficiency of provider operations, and improving psycho-social supports to the patient and the family. CAMC systems will be targeted at HMOS and other organizations assuming capitated financial risk for the seriously and chronically ill. This market could represent one in which CAMC systems could provide billions of dollars per year in cost savings. PROPOSED COMMERCIAL APPLICATION: The commercial applications of the work and derivatives are quite large. In the specific domain of care for the elderly with a chronic medical problem(s), the market is well over 1 million households. At a price of $1,200 for software application components, this represents a market of over 1 billion dollars.